Fluorescence-guided surgery (FSG) is a surgical method
to selectively
visualize the tumor site using fluorescent materials with instrumental
setups in the operation rooms. It has been widely used in the surgery
of brain tumors, such as glioblastoma (GBM), which is difficult to
distinguish from normal tissue. Although FSG is crucial for GBM surgery,
the commercially available fluorescent materials for FSG have shown
serious adverse effects. To satisfy the clinical demand, we recently
reported reaction-based fluorescent probes based on a 4-chloro-7-nitrobenzofurazan
(NBD) fluorophore that can detect cysteine (Cys) and homocysteine
(Hcy), a biomarker of GBM, and their applications for the GBM diagnosis
and FSG. However, our probes have cellular toxicity issues arising
from the leaving group (LG) that is generated after the reaction of
the fluorescent probe and the analytes. In this study, we disclosed
a nontoxic fluorescent probe for sensing biothiols and their clinical
applications for real-time human glioblastoma visualization. Systematic
toxicity analysis of several LGs was conducted on several cell lines.
Among the LGs, 2-hydroxy-pyridine showed negligible toxicity, and
its fluorescent probe derivative (named NPO-o-Pyr) showed high specificity
and sensitivity (LOD: 0.071 ppm for Cys; 0.189 ppm for Hcy), a fast
response time (<5 min) to Cys and Hcy, and high biocompatibility.
In addition, NPO-o-Pyr can significantly detect the GBM site both
in actual clinical samples as well as in the GBM-xenografted mouse
model. We are confident that NPO-o-Pyr will become a new substitute
in FSG due to its capability to overcome the limitations of the current
fluorescent probes.